MEDICARE: SUZY MESSINGER PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	10919	CA
2	225200000X	Physical Therapy Assistant	2045037	TX

General Provider Information

NPI Number	:	1285016030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZY MESSINGER PTA

Provider Business Mailing Address
First Line	:	517 GRAYSON LN
Second Line	:
City	:	LAKE DALLAS
State	:	TX
Zip	:	75065-3483
Country	:	US
Telephone Number	:	214-908-0161
Fax Number	:

Provider Business Practice Location Address
First Line	:	517 GRAYSON LN
Second Line	:
City	:	LAKE DALLAS
State	:	TX
Zip	:	75065-3483
Country	:	US
Telephone Number	:	214-908-0161
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2015
Last Update Date	:	06/28/2015

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